Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Neuroepidemiology. 2018;50(3-4):201-206. doi: 10.1159/000488244. Epub 2018 Apr 26.
BACKGROUND/AIMS: Duchenne Muscular Dystrophy (DMD) has childhood onset, primarily affects males, and is usually fatal before the age of 40 years. Previous studies have indicated that this X-linked condition is more prevalent in whites than in blacks, but those were based on active surveillance, and limited to smaller populations and younger ages.
US death data were used to calculate mortality rates by race and ethnicity, with MD as either the underlying or multiple cause of death (MCD). Poisson approximation was used for confidence intervals; chi-square was used to compare rates.
From 2006 to 2015, there were 3,256 deaths in males <40 years with MD as MCD, and 71% of these were aged 15-29 years. For whites, the average annual death rate was 0.43/100,000, which was significantly higher (p < 0.0001) that that of blacks (0.28), American Indian/Alaska Natives (0.20), and Asian/Pacific Islanders (0.21). The rate for non-Hispanic whites (0.46) was significantly higher (p < 0.0001) than the rates for Hispanic whites (0.31), Hispanic blacks (0.07), and non-Hispanic blacks (0.29).
Since DMD is the primary cause of deaths in young males with MD, mortality rates are a reasonable proxy for the relative difference in racial prevalence. It appears that DMD is significantly more common in white males than in males of other races.
背景/目的:杜氏肌营养不良症(DMD)发病于儿童期,主要影响男性,通常在 40 岁之前致命。先前的研究表明,这种 X 连锁疾病在白种人中比在黑种人中更为普遍,但这些研究是基于主动监测,且仅限于较小的人群和较年轻的年龄。
使用美国死亡数据按种族和族裔计算死亡率,将肌营养不良症作为主要或多种死因(MCD)。使用泊松逼近法计算置信区间;使用卡方检验比较比率。
2006 年至 2015 年,有 3256 名 40 岁以下男性死于肌营养不良症作为 MCD,其中 71%的年龄在 15-29 岁之间。对于白人,平均年死亡率为 0.43/100,000,明显高于黑人(0.28)、美洲印第安人/阿拉斯加原住民(0.20)和亚裔/太平洋岛民(0.21)。非西班牙裔白人的比率(0.46)明显高于西班牙裔白人(0.31)、西班牙裔黑人(0.07)和非西班牙裔黑人(0.29)。
由于 DMD 是导致年轻男性肌营养不良症死亡的主要原因,因此死亡率是种族流行率相对差异的合理替代指标。看来 DMD 在白人男性中比在其他种族的男性中更为常见。